***Chapter 14: Psychological Disorders Flashcards
criteria for mental disorders
-statistical rarity
-subjective distress
-impairment
-societal disapproval
-biological dysfunction
demonic model
view of mental illness in which odd behavior, hearing voices, or talking to oneself was attributed to evil spirits infesting the body
medical model
perception that regarded mental illness as due to a physical disorder requiring medical treatment (start of asylums)
moral treatment
approach to mental illness calling for dignity, kindness, + respect for those with mental illness
deinstitutionalization
governmental policy in 1960s + 1970s that focused on releasing hospitalized psychiatric patients into the community + closing mental hospitals
psychiatric diagnoses across culturse
-psychologists have increasingly recognized that certain conditions are culture-bound—specific to one or more societies
-many mental disorders, especially those that are severe, appear to exist in most + perhaps all cultures
-ex: social anxiety out of fear of offending others in Japan
-ex: body integrity disorder in U.S. + Europe
DSM-5
official system classifying individuals with mental disorders with 18 different classes of disorders
-based on symptoms using a categorical model (NOT dimensional)
-contains valuable information such as prevalence of many mental disorders
-acknowledges the interplay of biological, psychological, + social influences (biopsychosocial approach)
-high level of comorbidity among many diagnoses
-may “medicalize normality”
research domain criteria (RDcC)
an alternative to DSM-5 studying + classifying mental disorders based on multiple dimensions
comorbidity
2 or more mental illnesses occurring together
prevlaence or comorbidity
Hillary, a psychiatrist, has noticed that many patient’s who have recently come to see her are diagnosed with bipolar disorder + also posttraumatic stress disorder (PTSD). Hillary’s observation is about the ____ of bipolar disorder + PTSD.
comorbidity only
what models are used
Elvin has been reading about how different cultures + societies have treated mental illness overtime. He recently read about a modern society A that attributes mental illness to supernatural beings that haunt the afflicted individual + use rituals with crystals to treat the individuals. He also read about modern society B that attributes all mental illness to physiological issues + attempts to treat mental illness by treating physical symptoms. Society A uses the ___ model + society B uses the ___ model to treat mental illness.
society A: demonic model
society B: medical model
somatic symptom disorder
anxieties about physical symptoms that are either medically verified or purely psychological in origin to the point of interfering with daily living; excessive preoccupation with symptoms
-does have physical symptoms
illness anxiety disorder
a disorder when an individual is overly preoccupied with having/getting a disease, no amount of reassurance can relieve their anxiety
-more about worrying about the illness, not always experiencing physical symptoms
generalized anxiety disorder (GAD)
continual feelings of worry, anxiety, physical tension, + irritability across many areas of life functioning
generalized anxiety disorder is more in females/males
females
what % of population has generalized anxiety disorder
2-3%
-often with other anxiety disorders including phobias + panic disorder
panic disorder
repeated + unexpected panic attacks, along with either persistent concerns about future attacks or a change in personal behavior in an attempt to avoid them
-panic attacks occur when nervous feelings gather momentum + escalate into intense bouts of fear, even terror; could occur rarely or daily for a while
-panic attacks typically peak within 10 minutes; sweating, dizziness, lightheadedness, racing heart, shortness of breath, feelings of unreality, fears of going crazy or dying
when does panic disorder typically develop
late adolescence + early adulthood, associated with a history of fears of separation from a parent during childhood
phobias
intense fear of an object/situation that’s greatly out of proportion to its actual threat
agoraphobia
a fear of being in a place/situation in which escape is difficult or embarrassing or in which help is unavailable in the event of a panic attack; outgrowth of panic disorder
specific phobia
phobias of objects, places, situations; may disappear with age
social phobia (social anxiety disorder)
intense fear of negative evaluation in social situations; much more than stage fright
obsessive-compulsive disorder (OCD)
condition marked by repeated + lengthy (at least 1 hour per day) immersion in obsessions, compulsions, or both
obsession
persistent idea, thought, or urge that is unwanted causing marked distress
compulsion
repetitive behavior/mental act performed to reduce/prevent distress, anxiety, shame, guilt, etc.
posttraumatic stress disorder (PTSD)
marked emotional disturbance after experiencing or witnessing a reversely stressful event
-ex: wartime combat, rape, natural disaster
-flashbacks are a hallmark of PTSD
-actively avoid thoughts, feelings, places, objects, conversations that remind the person of the event
-recurrent dreams of the trauma
-increased arousal as in difficulty sleeping + startling easily
body dysmorphic disorder
preoccupation with imaged or slight defects in their appearance
1/3 of body dysmoprhic patients also suffer from ____
OCD
Tourette’s disorder
repeated automatic behaviors
-motor tics
-vocal tics
-associated with OCD
motor tics
twitching + facial grimacing
vocal tics
grunting + throat clearing
explanations for anxiety disorders
-learning models of anxiety: anxious responses as acquired habits via classical, operant conditioning, observation, misinformation
-anxious people tend to catastrophize or exaggerate the likelihood of negative events, to interpret ambiguous situations as negative; with high levels of anxiety sensitivity
-genes influence people’s levels of neuroticism- a tendency to be high-strung, guilt-prone, + irritable setting the stage for excessive worry
major depressive disorder
-depressed mood; depressed mood is one of sadness, grief, despair, loneliness, emptiness, hopelessness, helplessness, teary feelings, + so forth
-loss of interest/pleasure in most or all activities
-weight loss or weight gain; decreased/increased appetite
-disturbed sleeping patterns
-lethargy/listlessness or agitation
-fatigue or loss of energy
-feelings of worthlessness or excessive inappropriate guilt
-difficulty concentrating or making decisions
-recurrent thoughts of death or thoughts about suicide
women/men are more likely to experience depression
women are 2x more likely
explanations for major depressive disorder
-depression + life events (losing something we value dearly)
-interpersonal model (depression as a social behavior; people with depression often elicit hostility + rejection from others, which in turn maintains/worsens their depression)
-behavioral model (depression as a loss of reinforcement; when people with depression try different things + receive no payoff, they eventually give up)
-cognitive model (depression as a disorder of thinking)
-learned helplessness (the tendency to feel helpless in the face of events one can’t control)
-genetics (low levels of the neurotransmitter epinephrine; decreased levels of dopamine related to reward; inflammation; variations in the serotonin transporter gene; stress-sensitive gene; diminished neurogenesis, reduced hippocampal volume)
interpersonal model of depression
-depression as a social behavior
-people with depression often elicit hostility + rejection from others, which in turn maintains/worsens their depression
behavioral model of depression
-depression as a loss of reinforcement
-when people with depression try different things + receive no payoff, they eventually give up
cognitive model of depression
depression as a disorder of thinking
depression is associated with low levels of which neurotransmitters
epinephrine + dopamine
Beck’s cognitive triad
-negative views about the world, oneself, + the future
-world: “everyone is against me because I’m worthless”
-oneself: “I’m worthless + inadequate”
-future: “I’ll never be good at anything”
bipolar disorder
condition marked by a history of at least 1 manic episode
women/men are more likely to have bipolar disorder
equally common
what event is usually associated with bipolar disorder
more than 1/2 the time, a major depressive episodes precedes/follows a manic episode
manic episode
marked by decreased need for sleep + activity, inflated talkativeness, irresponsible, dramatically elevated mood, greatly heightened energy + self-esteem, increased behavior
which disorder is most genetically influenced
bipolar disorder
brain activity in dipolar disorder
-increased activity in amygdala
-decreased activity in prefrontal cortex
myth/reality
talking to individuals with depression about suicide makes them more likely to commit the act
myth
-reality: talking to individuals with depression about suicide makes them more likely to ask for help
myth/reality
suicide is almost always completed with no warning
myth
-reality: many/most individuals who commit suicide communicate their intent with others, which gives us the opportunity to seek help
myth/reality
as severe depression lifts, people’s suicide risk decreases
myth
-reality: : as a severe depression lifts, the risk of suicide actually increases in part because individuals have more energy to attempt the act
myth/reality
most people who threaten suicide are seeking attention
myth
-reality: although attention seeking motivates some suicide behaviors, most suicidal acts stem from severe depression + hopelessness
myth/reality
people who talk a lot about suicide never commit it
myth
-reality: talking about suicide is associated with a considerably greater risk of suicide
what is the single best predictor of suicide
a previous attempt
-30-40% of all people who kill themselves have made at least 1 prior attempt
when can you diagnose a personality disorder
ONLY when personality traits first appear by adolescence, are inflexible, stable, expressed in a wide variety of situations, lead to distress/impairment
borderline personality disorder
condition marked by extreme instability in mood, identity, + impulse control
-mostly in women
-interests + life goals frequently shift dramatically
-relationships alternate from extremes of worshipping others from 1 day to hating them the next
-stable instability
-impulsive + self-destructive including drug abuse, sexual promiscuity, overeating, self-mutilation, suicidal attempt
-emotional dysregulation disorder may be a better name
psychopathic personality
condition marked by superficial charm, dishonesty, manipulativeness, self-centeredness, risk-taking
-not formally a psychological disorder
-mostly in males
-overlaps moderately with diagnosis of antisocial personality disorder (ASPD), marked by a lengthy history of irresponsible/illegal actions
-informally known as psychopath or sociopath
-marked by a distinctive set of personality traits: guiltless, dishonest, manipulative, callous, self-centered
brain activity associated with psychopathic personality
underacctivity of amygdala in response to fear-related stimuli
dissociative disorders
condition involving disruptions in consciousness, memory, identity, or perception
depersonalization/derealization disorder
condition marked by multiple episodes of depersonalization, derealization, or both
depersonalization
disconnected from thoughts
derealization
disconnected from surroundings, environment
dissociative amnesia
inability to recall important personal information (most often related to a stressful experience) that can’t be explained by ordinary forgetfulness
dissociative identity disorder (DID)
condition characterized by the presence of 2 or more distinct personality states that recurrently take control of the person’s
-characterized by multiple intact personalities
what disorder do you see in this scenario
Sierra is a 34-year-old school administrator, who entered into intensive psychotherapy to deal with her issues. She tended to heavily idealize new men she met, as long as they met certain criteria (in terms of their looks, intelligence, + job prospects). For the first month or 2 of dating, the new relationship would be all she described. Nothing else mattered in her life + all efforts to engage her in reflection about the man in question (about whom she often offered very early signs that all was not as rosy as she believed) were met with an angry accusation that nobody wanted her to be happy. She would fantasize about marriage + their future together for several sessions + then, without any apparent warning, he would disappear from her sessions. Upon a psychologist’s inquiry, she would mention that she had stopped seeing him because he was a loser. Not only was he a terrible disappointment + a loser but he had always been a terrible disappointment + a loser. She would become enraged at her ex-boyfriend + threaten to either kill him or herself.
borderline personality disorder
-because keyfeature is stable instability
schizophrenia
severe disorder of thought + emotion associated with a loss of contact with reality
schizophrenia symptoms
-delusions
-hallucinations
-disorganized speech
-grossly disorganized behavior/catatonia
schizophrenia symptoms
delusions
strongly held fixed beliefs with no basis in reality
-ex: belief that one has turned into a deer
schizophrenia symptoms
hallucinations
sensory perceptions that occur in the absence of an external stimulus, mostly auditory
-ex: go over + tell him to shut up
schizophrenia symptoms
disorganized speech
resulting from thought disorder, word salad, jumbled speech, lack of usual word associations
schizophrenia symptoms
grossly disorganized behavior/catatonia
deteriorated self-care, personal hygiene, motivation, bizarre/rigid postures, pacing aimlessly, parrotlike speech (echolalia), bouts of frenzied, purposeless motor activity
catatonia
abnormality of behavior, disturbed mental state
echolalia
parrotlike speech
difference between DID + schizophrenia
-DID: characterized by multiple intact personalities
-schizophrenia: split mind; characterized by 1 shattered personality
brain abnormalities associated with schizophrenia
-enlarged ventricles indicating brain deterioration, also associated with thought disorder
-abnormity in size + symmetry of brain structure such as hemispheres
-less active frontal lobe
neurotransmitter differences associated with schizophrenia
abnormalities in dopamine receptors
genetic influences associated with schizophrenia
as genetic similarity increases, so does risk of schizophrenia
when are individuals with schizophrenia more prone to relapse
when their relatives display high expresseed emotion (criticism, hostility, + over-involvement)
diathesis-stress model
proposes that schizophrenia, along with many other mental disorders, is a joint product of genetic vulnerability (diathesis) + stressors that trigger this vulnerability
word salad
confused/untintelligable mixture of words
Emilia has schizophrenia. Her symptoms include ____, such as when she says sentences like “tomorrow cake knife house together talk sit fun”. Another symptom is ____, in which she repeats the first 3 words she hears on TV for the rest of the days. She also shows ____ when she becomes convinced that the medicine is poison that her deceased mom wants her to take.
-word salad
-echolalia
-delusions
Autism spectrum disorder (ASD)
includes autistic disorder (autism) + Asperger’s disorder (a less severe form of autism)
-marked by persistent deficits in communication, social bonding, + imagination, sometimes accompanied by intellectual impairment
2 major symptoms of autism spectrum disorder
-social impairment
-repetitive/restrictive behaviors
attention-deficit/hyperactivity disorder (ADHD)
childhood condition marked by excessive inattention, impulsivity, + activity
what % school age children have ADHD
5%
boys/girls are more likely to develop ADHD
boys are 2-4x more likely
what % children with ADHD continue to display ADHD symptoms into adolescence + adulthood
30-80%
subtype 1 ADHD
ADHD with hyperactivity
subtype 2 ADHD
without hyperactivity, predominantly inattention
when do signs of ADHD occur vs when are they diagnosed
-occur in infancy
-aren’t diagnosed until elementary school
is ADHD genetically influenced
yes- with heritability as high as 0.8
heritability for ADHD
abnormality in genes that influence:
-serotonin, dopamine, + norepinpehrine
-smaller brain volume
-decreased activation in the frontal areas of brain
early-onset bipolar disorder
-diagnosis for early-onset bipolar disorder increase from 0.42% to 6.67% in 2003
-children with rapid mood changes, reckless behavior, irritability, + aggression are more likely to be diagnosed with early-onset bipolar disorder
most children with ADHD also have ___
bipolar disorder
DSM-5’s new category
disruptive mood dysregulation disorder- for children with persistent irritability + frequent behavior outbursts
